Countryside Adult Family Care Home

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

ALLS3163 Issued in ME

Legal business name

COUNTRYSIDE ADULT FAMILY CARE HOME

Practice address

1334 Long Plains Rd
Buxton, ME 04093-6052

Phone

(207) 929-5787

NPI assigned

Apr 24, 2009

Last updated

Apr 24, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Nancy Tapec Atienza

Title

Administrator

Phone

(207) 929-5787

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1240531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240531200000",
    "number": "1124262845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1334 LONG PLAINS RD",
            "city": "BUXTON",
            "state": "ME",
            "postal_code": "040936052",
            "telephone_number": "207-929-5787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1334 LONG PLAINS RD",
            "city": "BUXTON",
            "state": "ME",
            "postal_code": "040936052",
            "telephone_number": "207-929-5787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRYSIDE ADULT FAMILY CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-24",
        "last_updated": "2009-04-24",
        "status": "A",
        "authorized_official_last_name": "ATIENZA",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "TAPEC",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "207-929-5787",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "ME",
            "license": "ALLS3163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexander Alton Comeau, LMSW-CC
• Krystina Cook, MS, OTR/L
• Christina Corbin-Price, IPDH
• Maria Corridore, MS, OTR/L, CLT, CHT
• Countryside Adult Family Care Home
• Russell Curl, PT, DPT
• Paige Curran
• Cada Driscoll, MS, RDN, LD
• William Henry Fenn, DMD
• Jenessa Fisk, OTR/L

• Assisted Living Facility in Buxton, ME
• Providers in Buxton, ME by specialty
• Assisted Living Facility in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.